'Tardy' govt urged to overhaul aged care

The federal government has been too slow to address serious defects in the regulation of aged care, royal commission lawyers say.

They want the "tardy" government to overhaul the system, saying the current regulatory framework has too often failed to detect risks and substandard care.

There needs to be a new system that places the people receiving the care at the centre of quality and safety regulation, senior counsel assisting the aged care royal commission Peter Gray QC argued.

"Fundamental change to the regulatory system for aged care is needed," Mr Gray said in closing a week-long public hearing in Brisbane.

"We submit that piecemeal adjustments and improvements are unlikely to achieve what is required."

Mr Gray criticised the government for being slow to implement the recommendations of an independent review in 2017, which followed the Oakden nursing home scandal in South Australia.

He said evidence at the royal commission's regulation hearing exposed serious defects at the operational and design levels, but equally concerning was the fact the defects were old news.

"Government has been tardy in implementing previously-recommended reforms.

"There's been no sense of urgency."

Mr Gray said the government had yet to even reach a decision on some aspects of the review's recommendations.

"Government has been unable to deal with the challenge posed by the need for reform or at least to do so promptly."

Review co-author Professor Ron Paterson told the hearing he was disappointed by the government's slowness in implementing the recommendations and suspected some were not actually being progressed.

Mr Gray said both the regulatory model for aged care and the culture of the regulators - the quality commission introduced in January and federal health department - need to change.

"Our contention is that the current regulatory system, which is focused on processes rather than actual outcomes and is based on minimum standards, is unlikely to provide an adequate basis for improving the quality of care and welfare of care recipients."

The current regulatory system too often failed to listen to the person receiving care and their family, Mr Gray argued.

"The voices of providers are predominant in the Australian system and appear to be highly influential in policy debates with ministers, departments, agencies and officials, but the voices of consumers, families and consumer advocates are relatively weak."

The royal commission will hold its next public hearing in September, focusing on younger people living in residential aged care facilities.